Why Are Many Men Reluctant to Get Help in Therapy When They Need It?

As a psychotherapist in private practice in New York City, I'm seeing more men seeking help now than I did 20 years ago, but many men are still reluctant to get help in therapy when they need it.

Why Are Many Men Reluctant to Get Help in Therapy?

According to a 2020 survey, even though more men seek help now than before, there are many men who need help who don't seek it. In addition, fewer men seek help in  therapy compared to women.

Men Who Are Reluctant to Get Help in Therapy

Even though many well-known male athletes and celebrities have spoken openly about seeking help in therapy, there's still a stigma about men seeking help (see my article: Mental Health Awareness: Reducing the Stigma of Getting Help in Therapy).

Here are some of the most common reasons why men avoid getting help in therapy:

• A belief they must conform to traditional gender roles and that "being a man" means never showing emotional vulnerability

• They don't know how to show emotional vulnerability

• They're not sure what they feel

• Even if they know what they feel, they don't know how to talk about it

• A belief that going to therapy means they're "weak" (see my article: A Common Myth: Going to Therapy Means You're "Weak")

• Going to therapy makes them feel ashamed (see my article: Overcoming Shame)

• Going to therapy makes them feel embarrassed

• A belief they should know how to handle their problems on their own without getting help

• Psychotherapy is out of reach for them due to a lack of mental health services in their area or they can't afford it (in New York there are sliding scale therapy services in psychotherapy institutes with therapists in training who are supervised by senior therapists, including Institute For Contemporary Psychotherapy which also takes some health insurance).

How Can Men Learn to Talk About Their Problems?

Over the years, I have worked with many men who seek help in therapy because their partner encouraged them and, in some cases, insisted that they get help.

Here are some of the things I do to help men who seek help:

• Normalizing the Need For Help: Since I know many men don't know how to talk about their feelings, I start by trying to help them to get comfortable talking in sessions and normalizing how awkward it can be, at first, for anyone to talk to a therapist. I also provide them with psychoeducation about therapy including letting them know that many people start therapy with a degree of anxiety and ambivalence (see my article: Starting Therapy: It's Not Unusual to Feel Anxious and Ambivalent).

Men Who Are Reluctant to Get Help in Therapy

• Creating a Safe Space in Therapy Sessions: In order for clients to feel comfortable talking in therapy, I create a safe space for them by being compassionate, nonjudgmental and going at a pace that works for them.  

• Helping Clients to Relax: For clients who are anxious, I often start the session with a breathing exercise to help them transition from wherever they came from so they can relax and be present in the room.

• Starting Wherever They Want to Start: In our culture, it's generally considered more acceptable to talk about "stress" than anxiety or depression, so a lot of men (and women too) start therapy by saying they're experiencing "stress" and they just need some tips on how to manage their stress.  I will start wherever a client feels most comfortable, so if they want to talk about ways to manage stress, I'll start there.  But what usually happens, after these clients get comfortable talking to me, is that they begin to open up and talk about what is causing them stress including problems in their relationship, problems with their children, elder care issues, issues at work, unresolved trauma and so on.

Men Who Are Reluctant to Get Help in Therapy 

• Choosing Whether or Not to Work With Goals: Some clients like to set goals early in therapy. Others feel that setting specific goals feels like too much pressure. So, I allow clients to decide how they want to work.  At the same time, I want the sessions to be meaningful to them so we might need to find a balance so the therapy doesn't just "drift" in a scattered way.

• Helping Clients to Identify Their Feelings: Many men have been raised since early childhood to suppress or ignore their feelings so that, as adults, it's difficult for them to know what they feel. Therefore, helping these clients to recognize and identify feelings is often a significant part of the work.

Men Who Are Reluctant to Get Help in Therapy

• Using Humor and Lightheartedness: Using humor, when appropriate, can help clients to relax and open up. 

• Encouraging Self Compassion: This is an essential part of the work in therapy, especially for clients who have internalized harsh messages from early childhood about what it means to "be a man" (see my article: Acceptance and Self Compassion).

• Encouraging Self Care: Many men who are reluctant to get help in therapy are also reluctant to take care of their physical health and overall well-being, so encouraging self care is often an important part of the work (see my article: Self Care Is Not Selfish).

• Encouraging Support Outside of Therapy: The problem for many men is they don't talk to anyone about how they feel even if they have people in their life who would be supportive. In addition, many men don't have partners or close friendships, so encouraging them to develop an emotional support system outside of therapy is important (see my article: Overcoming Loneliness and Social Isolation).

Suicide Rates For Men

Men's mental health struggles often go undiagnosed because they avoid getting help.

In the United States, men represent about 79% of all suicides, which is four times higher than women.

Approximately 36,000 men commit suicide every year in the U.S. due to undiagnosed mental health and/or substance misuse problems.

Many of these deaths could have been prevented with professional help.

Note: If you or someone you know needs immediate help for suicidal thoughts, call 988, which is the suicide prevention lifeline or go to your nearest emergency room.

Getting Help in Therapy

The first step, which is making an appointment, is often the hardest.  

Getting Help in Therapy

If you have been struggling on your own, you could benefit from getting help from a skilled mental health professional.

Most clients who are initially reluctant to start therapy usually discover that therapy helps them to overcome their problems so they can lead a meaningful life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I have over 20 years of experience helping individual adults and couples for a variety of issues, including trauma (see my article: What is a Trauma Therapist?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at 917.742.2624 during business hours or email me.